Blogs

Ecstatic Molly Displays Her Deadly Side

In collaboration with the University of Texas, we are conducting a
survey to learn about people’s perceptions of online health
communication and celebrity diagnoses. We would like to know your
opinion. Click here to participate.

Molly is very popular.

Molly seems especially popular with the celebrity crowd.Miley Cyrus, Madonna and Kanye West sing about her.

Molly is a party girl.

But Molly is now showing her darker side, and it can be deadly.

Molly is the street name for MDMA (chemically 3,4-methylenedioxy-N-methylamphetamine), which is also the active ingredient in Ecstasy. Molly, short for "molecule", is considered by users to be "pure" MDMA, unlike Ecstasy, which generally is laced with other ingredients, such as caffeine or methamphetamine.

In the past two weeks there has been a disturbing rise in the number of overdoses and deaths attributed to Molly. On August 27, a 19-year-old from Derry, N.H. died at a Zedd concert at Boston's famous House of Blues. There were two overdoses the same night, with promoters cancelling the next night's concert.
Over the Labor Day weekend, New York City's massive Electric Zoo concert on Randalls Island was cancelled early when Molly was blamed for two fatal and four non-fatal overdoses.

What do I need to know about Molly?

Molly belongs to a class of drugs called phenethylamines, structurally similar to the amphetamines.
An amphetamine molecule contains a ring and a side chain.

By changing the side chain and adding different substitutions on the rings, chemists have made a number of different drugs with slightly differing effects. For example, metamphetamine (crystal meth) has a “methyl” side change. Other drugs made in a similar way include MDMA (“Ecstasy”), 2C-I, also known as “smiles”, and methylenedioxypyrovalerone (MPDV) (often used in “bath salts”).

Whereas Ecstasy is frequently laced with other ingredients such as caffeine or methamphetamine, Molly is supposed to be "purer," consisting only of MDMA. However, there is no real reason to expect that Molly is free of contaminants that can be found in any illegal drug, or that dealers don't mix MDMA with other drugs or fillers to increase their profits.

Molly can induce euphoria, a sense of intimacy with others, a decrease in anxiety, and increased energy. As such, it has become very popular with dance club and party-goers. As 22-year-old Kaitlin told the New York Times:

"It makes you really happy. It’s very loose. You just get very turned on — not even sexually, but you just feel really upbeat and want to dance or whatever."

MDMA is taken orally, usually as a capsule or tablet. Its effects last approximately 3 to 6 hours, although it is not uncommon for users to take a second dose of the drug as the effects of the first dose begin to fade.

MDMA acts by increasing the activity of three neurotransmitters, serotonin, dopamine, and norepinephrine. The emotional and pro-social effects of MDMA are likely caused directly or indirectly by the release of large amounts of serotonin, which influences mood (as well as other functions such as appetite and
sleep). Serotonin also triggers the release of the hormones oxytocin and
vasopressin, which play important roles in love, trust, sexual arousal,
and other social experiences.

This surge of serotonin caused by MDMA can deplete the brain of this important chemical, and can cause negative aftereffects. These include confusion, depression, sleep problems, drug craving, and anxiety. These aftereffects may occur soon after taking the drug or during the days or even weeks afterwards.

High doses of MDMA can interfere with the ability to regulate body temperature, resulting in hyperthermia. This can lead to damage and even failure of the liver, kidney and heart. Severe dehydration can result from the combination of the drug’s effects and the crowded and hot conditions in which the drug is often taken.

Some heavy users of MDMA experience long-lasting confusion, depression, sleep abnormalities, and problems with attention and memory.
Research in animals has shown that MDMA in moderate to high doses can be toxic to nerve cells that contain serotonin and can cause long-lasting damage to them.

Is Molly addictive? Research so far has shown varying results. We do know that some users report symptoms of dependence and withdrawal effects. Experiments have shown that animals will self-administer MDMA — an important indicator of a drug’s dependency potential.

Perhaps giving MDMA a more innocent name (Molly vs. Ecstasy) makes people feel they are using a safer drug. But as DEA spokesman Rusty Payne told CNN:

"(Suppliers) are making it look like something that is safe and easy to take, but in many cases, you're playing Russian roulette."

Emergency rooms around the country have seen Molly and MDMA-related ER visits double in recent years. The past week's tragic deaths of three young concertgoers attributed to Molly should act as a wake-up call. Young people need more information about this potentially dangerous drug.

Admirers often plaster "Have you seen Molly?" posters around clubs and concerts. Let's hope they don't find her.

Michele R. Berman, M.D. was Clinical Director of The Pediatric Center, a private practice on Capitol Hill in Washington, D.C. from 1988-2000, and was named Outstanding Washington Physician by Washingtonian Magazine in 1999. She was a medical internet pioneer having established one of the first medical practice websites in 1997. Dr. Berman also authored a monthly column for Washington Parent Magazine.

This survey is a poll of those who choose to participate and are, therefore, not valid statistical samples, but rather a snapshot of what your colleagues are thinking.

MedPageToday is a trusted and reliable source for clinical and policy coverage that directly affects the lives and practices of health care professionals.

Physicians and other healthcare professionals may also receive Continuing Medical Education (CME) and Continuing Education (CE) credits at no cost for participating in MedPage Today-hosted educational activities.